Frontiers of Health Services Management - Summer 2014 - (Page 39)

lamenting high utilization to getting to know our high utilizers. We are now making concerted efforts to integrate clinical services, to focus on care coordination- which includes coordinating the coordinators-and to partner with community and governmental organizations in building a network of care that historically would have been considered outside the purview of a hospital, much less healthcare in general. this is a step toward the community health business model promoted by Kindig and isham. Accountable Care Communities A collaborative, integrated, and measurable strategy that emphasizes shared responsibility for the health of the community, including health promotion and disease prevention, the national governors association (2013) suggests that accs "take the concept of medical homes and accountable care organizations one step further by fostering collaborations borne of shared responsibility among clinical and community sector participants to reform health systems in particular localities." Kindig and isham mention accs as one model with the potential for addressing total population health. The Integrator Role Kindig and isham appropriately highlight the importance of an "integrator," an organization that will pull together the various clinical and social services. Whether we like it or not, given our community presence, hospitals and healthcare organizations will be at the center of these population health dynamics. and even if we account for only 20 percent of health outcomes, we may always be expected by our communities and by business and government sectors to provide central leadership and do the population health "heavy lifting." that expectation will require that we play a role in both clinical and social initiatives. finding the appropriate mix between the two will be a challenge for any provider. the HealthPartners example featured by Kindig and isham and similar initiatives will be rare examples indeed unless and until payment models support this kind of work. But it is possible. as a point of reference, the actuarial analysis conducted for our cMMi proposal forecasted a reduction in Medicaid spending C hr is t op he r Da dl e z , FAC H E * 39 C o m m e n t a r y Some of our efforts reflect a move toward an accountable care community (acc) model that bridges clinical and community settings to address both the medical and the social needs of high-risk, high-cost, or vulnerable patients in an integrated manner consistent with the triple aim. in fact, we partnered with community Solutions and the Department of Mental Health and addiction Services in connecticut-as well as with nuHealth, the Health and Welfare council of long island (nY), and Health leads on long island-to submit a proposal to cMS's center for Medicare & Medicaid innovation (cMMi) for developing accs in Hartford county and nassau county. Accountable care community is a term that was first employed by the austen Bioinnovation institute in akron (aBia) to describe a multisector, community-based collaborative effort to transform healthcare in northeast ohio. the aBia (2012) defines an acc as access to quality services, and healthcare delivery. . . . It builds on initiatives to encompass not only the area's medical care providers, but also the public health system and community stakeholders whose work, taken together, spans the spectrum of the determinants of health.

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2014

Table of Contents

Frontiers of Health Services Management - Summer 2014